Meghana Mantha, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12014455A Issued in IN

Practice address

5240 Franklin St
Michigan City, IN 46360-7372

Phone

(219) 873-9000

NPI assigned

Apr 15, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717891200000",
    "number": "1134973290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19W235 GLOUCESTER WAY N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231004",
            "telephone_number": "703-786-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607372",
            "telephone_number": "219-873-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTHA",
        "first_name": "MEGHANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-06-09",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014455A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.